Embargoed for Release Until: Monday, October 16, 2000
Contact: Sharon Burns 202-973-2934
Stacey Ward 202-973-5879[email protected]
Colon Cancer Exams Save Lives, Lower Cancer Care Costs
Screening colonoscopies may cut number of deaths in half
NEW YORK, October 16, 2000 -- A broadly applied colonoscopy screening program could cut colon cancer deaths by 50 percent or more and lower the cost of colorectal cancer surgery and general cancer care, according to the results of new research presented at the 65th Annual Scientific Meeting of the American College of Gastroenterology (ACG) October 16 -- 18th.
Researchers from Duke University Medical Center led by Dawn Provenzale, M.D., sought to determine the costs and benefits of a broad-based colonoscopy screening program in a managed-care setting. Using a validated decision-analytical model and looking at more than 8,000 patients above age 50 in the Duke Managed Care System (DMCS), the investigators counted the number of endoscopies, endoscopic complications, surgeries, episodes of chemotherapy and radiation, cancer deaths, and related costs during a 10-year period.
For 8,300 patients over 50 years of age, the researchers use a published analytic model to calculate statistics for both the current screening strategy of annual fecal occult blood testing (FOBT) and for a screening colonoscopy program. Screening colonoscopy procedures involve passing a lighted fiber-optic tube into the colon, allowing direct visualization of any suspicious growths, which, once sighted also can be biopsied or removed during the same test. While the screening program would produce a four-fold increase in the number of colonoscopies (12,326 vs 3,187) and three times the number of complications (25 vs 8), compared with FOBT, the number of surgeries would be cut by more than half (50 vs 116), with a cost savings of nearly $1 million. The costs of chemotherapy and radiation would drop by 58 percent. More important, the death rate from cancer at the DMCS would be cut more than half (8 vs 17) by endoscopic screening, yielding a savings of $222,000 to the Center.
"Compared with screening mammography, which are common in current medical practice and costs $22,000 for every life year saved, colonoscopy is a bargain at $6,230 for every life year saved," said Provenzale. "Moreover, regular and early screening can dramatically improve a patient's prognosis and quality of life. Even though the additional direct cost of a colonoscopy screening program is large ($5,652,715), the expense can be justified by the savings obtained from a reduced utilization of cancer care and the number of cancer deaths avoided. Certainly, a screening program of this kind appears to be highly cost effective compared to other screening practices when used in a managed-care setting."
Colon cancer is the second leading cause of cancer death in the United States, trailing only lung cancer. More than 56,000 Americans will die in 2000 from the disease, and more than 130,000 new cases will be diagnosed this year. Previous research has shown that up to 90% of colorectal cancer deaths can be prevented by regular screening, early detection and timely removal of precancerous polyps.
Different types of screening strategies are available and recently comparison studies have been published. The College's journal, The American Journal of Gastroenterology, published new recommendations in an article authored by Drs. Rex, Johnson, Lieberman, Burt and Sonnenberg in April 2000, stating that colonoscopy is the preferred test for average risk patients beginning at age 50 and colonoscopy is needed at earlier ages in persons who have a history of colon cancer or other medical conditions that places them at increased risk.
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The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. Consumers can get more information on gastrointestinal disorders through the following ACG-sponsored programs:
* 1-800-978-7666 (free brochures on common gastrointestinal disorders, including ulcers, colon cancer, gallstones, and liver disease)* 1-800-HRT-BURN (free brochure and video on heartburn and GERD) * www.acg.gi.org (ACG's Web site)
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